| NPI | 1184860496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A100516) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA a100516) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2022-09-30 |